Search Results (57)

Background: Early childhood dental decay remains a pervasive chronic condition, and environmental toxicants—particularly lead—may exacerbate its development. This systematic review was designed to synthesize evidence on how lead exposure correlates with both the occurrence of carious lesions and aesthetic alterations in children’s primary teeth. Methods: A comprehensive search was conducted in PubMed, Scopus, and Web of Science through April 2025, selecting observational investigations that assessed the link between lead levels and primary-tooth decay in pediatric cohorts. Thirteen eligible studies, encompassing 44,846 participants aged 2–19 years, were included for qualitative synthesis. Aesthetics were screened using author-defined enamel-defect or discoloration endpoints; however, only three studies reported compatible metrics, precluding quantitative pooling. Heterogeneity in exposure matrices likewise ruled out meta-analysis. Results: Most studies reported a statistically significant association between higher lead burden and greater prevalence or severity of caries in primary teeth. Blood lead concentrations across studies ranged from means of 1.53 μg/dL to geometric means of 7.2 μg/dL. Notably, elevated lead was linked to increased decayed, missing, or filled surfaces—with an adjusted risk ratio of 1.14 (95% CI: 1.02–1.27) at levels below 5 μg/dL—and adjusted mean ratios of up to 2.14 for decayed or filled teeth when blood lead reached 5–10 μg/dL. Conclusions: Current evidence suggests that children’s exposure to lead may heighten the risk of caries and detract from the aesthetic quality of primary teeth. However, variability in study design, lead quantification methods, and confounder adjustment limit the consistency of findings. Mitigating lead exposure in early life could represent a valuable preventive strategy against dental decay in susceptible pediatric populations. Full article

This study aimed to assess dental caries status of 3- to 6-year-old preschool children in the Republic of Serbia. Stratified cluster sampling was implemented. Children were examined in four administrative regions of Serbia. Dental caries indices (decayed, missing, and filled) for deciduous teeth and the first permanent molar were recorded at the tooth level (dmft, DMFT) and surface level (dfs, DFS). In addition to cavitated caries lesions (ICDAS 3-6), visual changes in enamel (ICDAS 1-2) were recorded. This study included 1060 3-year-old and 1820 6-year-old children in Serbia. Fifty-six percent of 3-year-olds and 21% of 6-year-olds were caries-free. The mean dmft was 2.11 ± 3.45 for 3-year-olds and 4.46 ± 3.69 for 6-year-olds. The mean dfs was 2.62 ± 5.56 for 3-year-olds and 6.06 ± 6.33 for 6-year-olds. The decayed component was dominant in dmft/dfs. The prevalence of surfaces with initial lesion was 8% for 3-year-olds and 13% for 6-year-olds. Among children diagnosed with early childhood caries, 54% of 3-year-olds and 37% of 6-year-olds had a severe form. The mean DMFT was 0.15 ± 0.55, with only the first permanent molars being affected. Dental caries remains a significant public dental health issue among preschool children in Serbia. There is a noticeable trend of increasing numbers of decayed teeth as children progress through their preschool years. It is imperative to take corrective action enhance the existing oral health prevention program in Serbia with the aim of achieving better dental health among preschool children. Full article

Background/Objectives: Children who undergo several dental extractions with general anesthesia (GA) may face considerable changes in their oral health-related quality of life (OHRQoL), but there is a lack of research on this issue in the Middle East. Aim: This study aimed to assess how the number of dental extractions performed under general anaesthesia due to caries impacts the oral health-related quality of life (OHRQoL) in children aged from three to six years. Methods: This prospective, single-center cohort study included parents of children aged 3–6 years undergoing dental treatment under general anaesthesia in Jeddah, Saudi Arabia. Parents completed the validated Arabic Early Childhood Oral Health Impact Scale (A-ECOHIS) before and after treatment to assess changes in OHRQoL. The number of extractions was recorded, and patients were grouped based on extraction frequency: high (≥mean) and low (<mean). Pearson’s correlation was used to evaluate the relationship between the number of extractions and the effect size of OHRQoL. Results: Ninety-three participants met the inclusion criteria and agreed to participate in this study. The mean age of the children was 4.88 years (SD ± 1.06). The most common procedure performed was extraction, with a mean of 5.34 (SD ± 5.53), followed by stainless-steel crown application, with a mean of 4.03 (SD ± 2.01). No correlation between the number of extractions and the effect size in the change in OHRQoL was noted (Pearson r = −0.002, p-value = 0.98). Conclusions: Dental extractions were the most common procedure performed under GA. While multiple extractions showed no significant association with the effect size of OHRQoL, overall treatment under GA led to significant improvement. These findings highlight the need for timely intervention, parental education, and comprehensive treatment protocols. Utilizing tools like ECOHIS may aid in prioritizing high-risk cases and optimizing resource allocation in pediatric dental care. Full article

Objectives: This systematically scoping review aims to evaluate the therapeutic potential and clinical benefits of specific Lactiplantibacillus plantarum (L. plantarum) strains in human health, identifying their strain-specific effects across various medical conditions. Methods: Following the PRISMA for Scoping Reviews (PRISMA-ScR) guidelines and employing the PICO framework, a comprehensive literature search was conducted in the PubMed and Embase databases to identify relevant studies published up to December 2023. Inclusion criteria were rigorously applied to ensure the selection of high-quality studies focusing on the clinical application of distinct L. plantarum stains. Results: This review analyzed several unique strains of L. plantarum across 69 studies, identifying several therapeutic benefits. L. plantarum 299v effectively improved gastrointestinal symptoms, enhanced oral health, and reduced systemic inflammation. L. plantarum IS-10506 exhibited notable immunomodulatory effects, especially in managing atopic dermatitis. L. plantarum LB931 showed promise in decreasing pathogenic colonization, supporting women’s vaginal health. Additionally, L. plantarum CCFM8724 demonstrated potential in reducing early childhood caries, highlighting its promise in pediatric oral care. Conclusions: The therapeutic potential of L. plantarum is extensive, with certain strains exhibiting promising clinical benefits for specific health concerns. The findings of this review advocate for the integration of L. plantarum strains into clinical practice, emphasizing the need for further research to elucidate their mechanisms of action, optimal dosages, and long-term safety profiles. Full article

Background and Objectives: Severe early childhood caries (S-ECC) is a chronic infectious disease with a multifactorial etiology which has not been completely elucidated. Research on the role of oxidative stress in the etiopathogenesis of oral diseases suggests that the level of local antioxidants plays an important role in determining susceptibility to caries. This study aimed to demonstrate that the host’s redox imbalance, modified by genetic polymorphisms, may influence the onset and severity of S-ECC. Materials and Methods: A total of 110 patients were included in the study (59 diagnosed with S-ECC and 51 healthy controls). Upon initial appraisal, the DMFT (decayed-missing-filled teeth) index was determined, and epithelial cells were collected using oral swabs for genomic DNA extraction. Genotyping of SOD2 (rs4880) and GPX1 (rs1050450) was performed using TaqMan SNP genotyping assays and real-time polymerase chain reaction (PCR). Results: According to the results of the present study, there was a significant difference between the frequency of the reference genotype and variants for rs4880 (p = 0.0303). Subjects carrying the AG and GG variant genotype of rs4880 were significantly associated with a high DMFT value (p = 0.0005). However, no significant difference was found between the genotypes for rs1050450, nor was there an association with the severity of S-ECC. Conclusions: The AG and GG variant genotypes of the SOD2 polymorphism (rs4880) increase the severity of caries in preschoolers and predispose patients to develop carious lesions, especially when associated with certain feeding practices and infrequent toothbrushing. This observation emphasizes that host sensitivity to caries is a crucial factor in the onset and development of carious lesions in primary dentition, despite the main contributing factors to this pathology. The rs1050450 polymorphism was not associated with the severity of S-ECC. Full article

Background/Objectives: Childhood cancer is the leading cause of death among children, although medical advances are improving the prognosis. During cancer treatment, nausea or vomiting may occur and eating habits may become irregular; therefore, it is important to prevent the development of oral diseases. We encountered a childhood cancer patient with rapidly progressive multiple dental caries, and this report describes the progress. Methods: A boy aged 2 years 9 months was referred for perioperative oral management. No caries were detected in the oral cavity at the initial visit. Results: As the patient had difficulty eating because of nausea and vomiting during cancer treatment, he began to consume probiotic drinks frequently. At 8-month follow-up, dental caries localized to the primary molars was detected. However, caries had occurred in all erupted teeth by 9 months later, confirming the diagnosis of severe early childhood caries. Dental treatment and long-term oral management contributed to good oral health except for dental abnormalities caused by chemotherapy. Conclusions: Childhood cancer patients, particularly at an early age, are at risk of rapid deterioration of oral disease even over a short time period. It is important to cooperate with medical or dental professionals from other hospitals to provide dietary and oral health instruction and continue long-term oral management to improve patients’ quality of life. Full article

Objectives: This study aimed to explore the levels of salivary interleukin-6 (IL-6) in children diagnosed with Early Childhood Caries (ECC) and Rampant Caries (RC). Additionally, it sought to determine whether salivary IL-6 levels vary with the increased activity or number of carious lesions in children with ECC and RC. Methods: A cross-sectional study was conducted at RAK College of Dental Sciences (RAKCODS), Ras Al Khaimah, UAE. Ethical approval was obtained, and 100 children aged 4 to 12 years were selected. Participants were divided into ECC and RC groups, each containing study and control subgroups of 25 children each. The study groups were children who had active carious lesions and the control groups were those children who had no active carious lesions. All of these children were screened and included as a part of the community engagement of the clinics. Saliva samples were collected and analyzed for IL-6 levels using an ELISA kit. Dental examinations and data collection adhered to standardized procedures, including specific clinical criteria for diagnosing ECC and RC and calibrated examiners to ensure consistent clinical assessments. Statistical analyses were conducted to compare salivary IL-6 levels between the study and control groups of each RC and ECC group and a test was also performed to assess the relationship between salivary IL-6 levels and the severity of dental caries. Results: This study found significantly higher mean salivary IL-6 levels in children with ECC (19.023 pg/mL) and RC (21.45 pg/mL) compared to their respective control groups (ECC: 6.42 pg/mL, RC: 11.43 pg/mL), with p-values < 0.0001. Strong positive correlations were observed between IL-6 levels and increased caries activity or severity, with Pearson’s correlation coefficients of 0.961 for ECC and 0.954 for RC. Conclusions: This study concludes that significantly elevated salivary IL-6 levels are observed in children with ECC and RC. Furthermore, salivary IL-6 levels were found to rise in correlation with the increase in number of carious lesions. These findings support the potential of salivary IL-6 as a biomarker for assessing caries severity and highlight the need for future research to explore diverse populations and additional clinical parameters. Full article

Background/Objectives: Early childhood caries (ECC) is a widespread and severe oral health problem that potentially affects the general health of children. Visual–tactile examination remains the diagnostic method of choice to diagnose ECC, although visual examination could be automated by artificial intelligence (AI) tools in the future. The aim of this study was the external validation of a recently published and freely accessible AI-based model for detecting ECC and classifying carious lesions in dental photographs. Methods: A total of 143 anonymised photographs of anterior deciduous teeth (ECC = 107, controls = 36) were visually evaluated by the dental study group (reference test) and analysed using the AI-based model (test method). Diagnostic performance was determined statistically. Results: ECC detection accuracy was 97.2%. Diagnostic performance varied between carious lesion classes (noncavitated lesions, greyish translucency/microcavity, cavitation, destructed tooth), with accuracies ranging from 88.9% to 98.1%, sensitivities ranging from 68.8% to 98.5% and specificities ranging from 86.1% to 99.4%. The area under the curve ranged from 0.834 to 0.964. Conclusions: The performance of the AI-based model is similar to that reported for the internal dataset used by developers. Further studies with independent image samples are required to comprehensively gauge the performance of the model. Full article

Early childhood caries (ECC) is not merely a problem of the tooth; rather, it has negative impacts on the child’s growth and development and oral health-related quality of life. The prevalence of ECC varies widely, and more variance is observed between countries than continents, and it changes over time. The current cross-sectional study aimed to determine ECC’s prevalence, associated factors, and severity. This study was conducted in the Dental Clinic Complex, North Riyadh, KSA. The study sample included 306 participants between 36 and 71 months of age. A questionnaire was developed to collect information from participants. The decaying and filled teeth (DMFT) index was used to estimate the prevalence of caries. The study results revealed the prevalence of ECC to be 76% among 36- to 71-month-old children in North Riyadh. ECC is influenced by socioeconomic factors like maternal occupation, education, oral hygiene habits, and dietary patterns. Also, it was found that exclusively breastfed children have lower ECC odds (68.1% vs. 83.6%, p = 0.001), while the intake of more than three between-meal sugar-containing snacks/beverages per day increases the likelihood of ECC (63.5% vs. 79.8%, p = 0.006). The researchers recommend encouraging breastfeeding as it correlates with lower ECC prevalence, in addition to establishing effective oral hygiene practices for preschool children. Full article

Background: This cross-sectional study aimed to identify the prevalence of Candida albicans and Malassezia globosa in children with severe early childhood caries and caries-free children in Hong Kong. Methods: This study first recruited a total of 80 children aged between 48 and 72 months old, 40 children with severe early childhood caries, and 40 caries-free children. The children were then further divided into four groups, with 20 children in each group: Group 1: Severe early childhood caries—C. albicans, Group 2: Severe early childhood caries—M. globosa, Group 3: Caries-free—C. albicans and Group 4: Caries-free—M. globosa. Saliva, plaque, and caries lesion samples were collected from participants with severe early childhood caries, while only saliva and plaque samples were collected from caries-free participants. Caries status of the primary molars was assessed using WHO’s decayed, missing, and filled tooth index, and the severity of cavitated lesions was determined based on International Caries Diagnosis and Assessment System criteria as caries code 5 or 6. The samples were analyzed using an Internal Transcribed Space and Quantitative Real-Time Polymerase Chain Reaction. Results:C. albicans was more prevalent in saliva and plaque samples of severe early childhood caries than in the caries-free group. Proportion of C. albicans in both saliva and plaque samples differed significantly between severe early childhood caries and caries-free groups (p < 0.05). Within the severe early childhood caries group, the proportion of children with C. albicans varied between 6 and 46%. No significant difference in M. globosa load was found between plaque samples of the severe early childhood caries and caries-free groups (p = 0.159). Conversely, no significant difference in M. globosa load was observed between saliva samples of severe early childhood caries and caries-free groups (p = 0.051). Conclusions: This study demonstrated a strong association between C. albicans and severe early childhood caries. M. globosa was detected in both the caries-free and severe early childhood caries groups, albeit at low levels. Full article

Background: Severe early childhood caries (S-ECC) is recognized as a significant chronic disease which affects the quality of life starting at very young ages and has a very rapid evolution towards pulp complication and loss of dental tissue. Children with a high caries index DMFT are more likely to develop high levels of dental anxiety, which will influence the degree of cooperation during dental procedures. Emotions play an important role in the psychosomatic development of children, and all the factors that contribute to the modeling of these emotional states must be known and taken into consideration. Aim: The aim of this study was to assess the association between dental anxiety in children with S-ECC and the color preferences for the components of the dental environment to reduce the levels of dental anxiety during medical visits. Material and Method: For this study, 91 children between 3 and 6 years of age diagnosed with S-ECC were selected from the Pediatric Dentistry Department of UMFST from Targu Mures and from a private dental office. The level of dental anxiety was determined by measuring the pulse rate, and a questionnaire was completed to establish the color preferences for the dental office environment and the dentist’s attire. For this purpose, six different colors and their variants with three shades less intensity were chosen by using RGB (Red, Green, and Blue) identification codes for each color. Result: The results showed that there was a statistically significant difference between the age of the subjects and dental anxiety levels, but there was no significant correlation between the DMFT score and dental anxiety. Also, the results showed that there was no significant difference between girls and boys when choosing the colors preferred by them for the dental office, but when comparing the colors that represented happiness, significant statistical difference was found between the girls’ and boys’ groups (p = 0.0039). For all the subjects, the colors associated with happiness were light yellow and pink, while the colors associated with anxiety were red and dark blue. Conclusion: The data obtained showed that dental anxiety is strongly influenced by age, and an important role in inducing positive emotions is played by the dental environment if dressed in specific colors in order to reduce dental anxiety and create familiar conditions, especially for young children with S-ECC. Full article

Artificial intelligence (AI) has been recently introduced into clinical dentistry, and it has assisted professionals in analyzing medical data with unprecedented speed and an accuracy level comparable to humans. With the help of AI, meaningful information can be extracted from dental databases, especially dental radiographs, to devise machine learning (a subset of AI) models. This study focuses on models that can diagnose and assist with clinical conditions such as oral cancers, early childhood caries, deciduous teeth numbering, periodontal bone loss, cysts, peri-implantitis, osteoporosis, locating minor apical foramen, orthodontic landmark identification, temporomandibular joint disorders, and more. The aim of the authors was to outline by means of a review the state-of-the-art applications of AI technologies in several dental subfields and to discuss the efficacy of machine learning algorithms, especially convolutional neural networks (CNNs), among different types of patients, such as pediatric cases, that were neglected by previous reviews. They performed an electronic search in PubMed, Google Scholar, Scopus, and Medline to locate relevant articles. They concluded that even though clinicians encounter challenges in implementing AI technologies, such as data management, limited processing capabilities, and biased outcomes, they have observed positive results, such as decreased diagnosis costs and time, as well as early cancer detection. Thus, further research and development should be considered to address the existing complications. Full article

Background and Objectives: Early childhood caries (ECC) is a multifactorial, biofilm-mediated, sugar-related, dynamic disease of primary dental hard tissues occurring in varying degrees of severity in infants and toddlers. Untreated ECC may lead to pain, infections, and severe systemic complications. The aim of this study was to systematically review and evaluate the scientific evidence on the cost-effectiveness of treatment decisions in ECC in infants and toddlers. Materials and Methods: Observational epidemiological studies, i.e., cohort studies, case–control studies, and randomized controlled trials, reporting cost-effectiveness of treatment decisions in ECC in infants and toddlers were included in the systematic review following the PRISMA guidelines. Using an ad hoc search with search terms or keywords (MeSH), electronic databases Embase, MEDLINE via PubMed, Scopus, and gray literature were searched. Results: The search identified 494 articles, of which 446 remained after removing duplicates. A total of 417 articles were excluded after title and abstract evaluation; 29 full-text articles were screened for eligibility, and five articles were discarded. Twenty-four full-text articles were included in the systematic review, assigning 17 to prevention and seven to restoration. Results were heterogeneous; comparability of included studies is difficult because of the different methodologies used. Conflicting efficacies were demonstrated for different interventions implemented, and cost-effectiveness data were documented. Conclusions: Socioeconomic, cultural, and ethnic differences must be considered when comparing conditions in terms of cost-effectiveness. A paradigm shift from surgical towards preventive treatment decisions can be observed. Cost-effectiveness studies on therapies for ECC in infants and toddlers are needed to identify the best practice approach and the most cost-effective therapy decisions. Full article

Acute lymphocytic leukemia (ALL) is the most frequent form of all childhood leukemias, mostly affecting children between 2 and 4 years old. Oral symptoms, such as mouth ulcers, mucositis, xerostomia, Herpes or Candidiasis, gingival enlargement and bleeding, petechiae, erythema, mucosal pallor and atrophic glossitis, are very common symptoms of ALL and can be early signs of the disease. Secondary and tertiary complications, a direct effect of chemo and radiotherapy, are associated with more severe bleeding, higher susceptibility to infections, ulcerations, inflammation of the mucous membranes, osteoradionecrosis, xerostomia, taste alterations, trismus, carious lesions and dental abnormalities. Immunotherapy, though less toxic, causes oral dysesthesia and pain. Overall, the effects in the oral cavity are transient but there are long-term consequences like caries, periodontal disease and tooth loss that impair endodontic and orthodontic treatments. Also, dental abnormalities resulting from disturbed odontogenesis are known to affect a child’s quality of life. The medical dentist should identify these complications and perform appropriate oral care in tandem with other health professionals. Thus, poor oral hygiene can lead to systemic ALL complications. The aim of this review is to describe the oral complications in children with ALL who are undergoing chemo, radio or immunotherapy. Full article

Dental caries is a multifactorial disease with multiple risk factors. Vitamin D levels (VDLs) and vitamin D receptor polymorphisms (VDRPs) have been investigated for this reason. The aim of this narrative review is to investigate the relation and the factors affecting vitamin D deficiency (VDD), VDRP, Early Childhood Caries (ECC) and Severe Early Childhood Caries (S-ECC) in children (primary and mixed dentition) and dental caries risk in adults (permanent dentition). Additionally, we present a model incorporating factors and interactions that address this relationship. Methods: Three databases (PubMed/MEDLINE, Web of Science, Cochrane Library) were comprehensively searched until 17 January 2023 using the following keywords: “vitamin D”, “vitamin D receptor polymorphism”, “dental caries”, and “dental caries risk”, finding 341 articles. Two reviewers searched, screened, and extracted information from the selected articles. All pooled analyses were based on random-effects models. Eligibility criteria were articles using dmft/DMFT diagnostic criteria with calibrated examiners, probability sampling, and sample sizes. We excluded studies conducted on institutionalized patients. A total of 32 studies were finally used. Results: In most studies, TaqI, FokI, and BsmI polymorphisms affected the prevalence of dental caries. A strong correlation between ECC, S-ECC, and the prevalence of dental caries was reported in association with VDD and maternal intake of VD in primary dentition. Regarding the influence in mixed dentition, the results were found to be inconclusive. A slight positive influence was reported for permanent dentition. Conclusions: Factors affecting caries risk were maternal intake, socioeconomic factors, and level of VD. There is a certain need for more well-conducted studies that will investigate the association between VDR gene polymorphisms and the prevalence of dental caries in mixed and permanent dentition, specifically in adult patients. Full article